Vitamin D deficiency in school-age children is associated with sociodemographic and lifestyle factors

J Nutr. 2015 Apr;145(4):791-8. doi: 10.3945/jn.114.208280. Epub 2015 Feb 18.

Abstract

Background: There is concern about a reemergence of vitamin D deficiency in children in developed countries.

Objectives: The aims of this study were to describe vitamin D status in the Generation R study, a large multiethnic cohort of 6-y-old children in The Netherlands, and to examine sociodemographic, lifestyle, and dietary determinants of vitamin D deficiency.

Methods: We measured serum 25-hydroxyvitamin D [25(OH)D] concentrations in 4167 children aged 6 y and defined deficiency following recommended cutoffs. We examined the associations between subject characteristics and vitamin D deficiency with the use of multivariable logistic regression analyses.

Results: Serum 25(OH)D concentrations ranged from 4 to 211 nmol/L (median: 64 nmol/L), with 6.2% of the children having severely deficient (<25 nmol/L), 23.6% deficient (25 to <50 nmol/L), 36.5% sufficient (50 to <75 nmol/L), and 33.7% optimal (≥75 nmol/L) 25(OH)D concentrations. The prevalence of vitamin D deficiency [25(OH)D <50 nmol/L] was higher in winter (51.3%) than in summer (10.3%); and higher in African, Asian, Turkish, and Moroccan children (54.5%) than in those with a Dutch or other Western ethnic background (17.6%). In multivariable models, several factors were associated with vitamin D deficiency, including household income (OR: 1.74; 95% CI: 1.34, 2.27 for low vs. high income), child age (OR: 1.39; 95% CI: 1.20, 1.62 per year), child television watching (OR: 1.32; 95% CI: 1.06, 1.64 for ≥2 vs. <2 h/d), and playing outside (OR: 0.71; 95% CI: 0.57, 0.89 for ≥1 vs. <1 h/d). In a subgroup with dietary data (n = 1915), vitamin D deficiency was associated with a lower diet quality, but not with vitamin D intake or supplement use in early childhood.

Conclusions: Suboptimal vitamin D status is common among 6-y-old children in The Netherlands, especially among non-Western children and in winter and spring. Important modifiable factors associated with vitamin D deficiency were overall diet quality, sedentary behavior, and playing outside.

Keywords: 25-hydroxyvitamin D; children; cohort; determinants; predictors; vitamin D deficiency.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Child
  • Child, Preschool
  • Dietary Supplements
  • Female
  • Humans
  • Life Style*
  • Logistic Models
  • Male
  • Netherlands / epidemiology
  • Nutrition Assessment
  • Nutritional Status
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Seasons
  • Socioeconomic Factors*
  • Surveys and Questionnaires
  • Vitamin D / administration & dosage
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / blood*
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / epidemiology*

Substances

  • Vitamin D
  • 25-hydroxyvitamin D